Spinal epidural hemangioma, mostly cavernous, is a rare lesion with many radiological mimics that has diagnostic difficulty. They can extend from one to multiple vertebral levels and may or may not be associated with vertebral hemangiomas. We are reporting a case of young adult presenting with features of compressive myelopathy. Plain and contrast-enhanced magnetic resonance imaging showed a large spinal epidural lesion extending from C7 to D10 vertebral levels with extension into adjacent neural foramina and paravertebral spaces. There were also signal changes in bodies and posterior elements of dorsal vertebrae. A provisional diagnosis of lymphoma was made. The patient was operated for decompression and histopathological diagnosis of cavernous hemangioma was made. As in our case, a review of literature shows that epidural cavernous hemangioma of spine may extend to multiple vertebral levels and difficult to diagnose on pre-operative imaging. However, such a long segment epidural cavernous hemangioma has not been reported in literature. Furthermore, we should be aware of these rare lesions to include it in our differential diagnosis the spinal epidural lesions for early diagnosis and management.
